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What is a provider? A provider is a health care professional who takes care of patients. This may be a doctor, a nurse practitioner, behavioral health provider, or other health care professional. Even if you aren’t sick now, it’s important to choose a primary care provider and to schedule your first appointment. Your PCP oversees your total health care and may work with other care providers and specialists to keep you healthy. CHPW members can browse our Provider Network…

Your Primary Care Provider, sometimes called PCP, is the provider you see the most. They will get to know you and help you keep track of your health over time. If you’re an adult, your primary care provider may be called a family physician or doctor, internist, general practitioner, nurse practitioner, or physician assistant. Your child or teenager’s provider may be called a pediatrician. If you’re elderly, your provider may be called a geriatrician. It is important to know your primary…

Know before you go: Not all types of providers and facilities take all insurance plans or types of coverage. -Call your insurance company, look at their website, or check your member handbook to find providers in your network who take your health plan. Tell them if you’re looking for something particular. -If you already have a provider you like and want to keep working with, call their office and ask if they accept your coverage. Keep in mind that most of the time you’ll pay more to see a…

Get health coverage for you and your family before you get sick. Health coverage is the first step to better health and well-being. Health coverage helps pay for seeing a health care provider, medications, hospital care, and special equipment when you’re sick. It is also important when you’re not sick. Most coverage includes immunizations for children and adults, annual wellness visits, health screenings, and more for free. Start leading a healthier life now! #health #family #wellness

For some services, your health plan may require you to first get Preauthorization (also called prior authorization, prior approval, or precertification) which is a decision by your health plan that a health care service, treatment plan, prescription drug, or durable medical equipment is medically necessary. Ask your plan if you need prior authorization before you visit your provider. Learn more: http://chpw.org/health-map/step-4

When you are calling to make your first appointment with your doctor, let the receptionist know if you have a speech or hearing disability or a mobility issue. They will help you make any necessary arrangements. If you have no way to get to your doctor appointment, you might be able to get some help with transportation. The appointment must be for services allowed by your health plan. The transportation will be the most appropriate and least costly, but is at no cost to you.

What is a Network? A Network is the facilities, providers, and suppliers your health insurer has contracted with to provide health care services. Your insurance company can tell you which providers are “in-network” (they may also be called “preferred-providers” or “participating providers”). If a provider is “out-of-network,” they are not approved by your health plan and it will cost you more to see them. Keep in mind: networks can change. Check with your provider each time you make an…

Your provider is there to help you stay healthy. Finding the right provider is one of the most important decisions you’ll make about your health care! Before making an appointment, call to ask questions: Are they in your network? Are they accepting new patients? Are they accepting patients with your health coverage? Where is the office located? What appointment times are available? Do they speak your language? Ask your friends or family if they have providers they like and what they like…

What is Medicare? Medicare is a federal government health insurance program. It is available to citizens or permanent residents of the United States who are 65 years or older or under the age of 65 with certain disabilities. Roughly 1 million Washingtonians are enrolled in Medicare. http://chpw.org/health-map/step-2

What is a plan formulary? The plan formulary is the list of drugs that are covered by your health plan. Your health plan will pay all or part of the costs for these drugs. Learn more: http://chpw.org/health-map/step-2